Hair loss is mainly caused by the combination of aging, hormonal changes and a family history of baldness. As a general rule, the earlier hair loss begins, the more severe baldness will become. Hair loss can also be caused by burns or trauma, in which case hair transplant surgery is considered a reconstructive treatment.

If you and your doctor come to the conclusion that a hair transplant is the best option for you, rest assured that certified plastic surgeons have been performing this procedure for over thirty years.

Baldness is said to be caused by poor circulation to the scalp, vitamin deficiencies, dandruff, and even excessive wearing of hats. All these theories have been demystified. It is also not true that hair loss is associated with the maternal grandfather's baldness, or that 40-year-old men who have never had hair loss will not be bald.

Hair transplant surgery can improve your appearance and self-confidence, but the results may not necessarily match your ideal. Before deciding to have surgery, think carefully about your expectations and discuss them with your surgeon. It is important to understand that all hair transplant techniques use your own hair. The goal of the surgery is to find the most efficient use for the existing hair. Candidates for hair transplant surgery must have healthy hair growth on the back and sides of the head to serve as donor areas. Donor areas are the places on the head from where grafts and flaps are taken. Other factors such as hair color, texture and curl can also affect the aesthetic result. There are a number of techniques used in hair transplant surgery. Sometimes two or more techniques are used to obtain the best results. Transplantation techniques such as punch grafts , mini-grafts, micro-grafts, follicular unit grafts are generally performed on patients who desire a more modest change in hair volume. Flaps, tissue expansion and scalp reduction are procedures recommended for patients who require a larger area.

Remember, there are limits to what can be achieved. An individual with little hair cannot be encouraged to undergo hair transplant surgery.

Some doctors estimate that one in five women experience some degree of hair loss, which is generally caused by aging, illness or hormonal changes after menopause. Women tend to experience a subtle thinning of hair throughout the scalp, rather than losing clumps of hair, as is common in men. To solve the problem, some women choose to wear a wig or hair extensions. Some women have success using topical medication. The effectiveness of these drugs varies in some patients and simply stops hair loss without stimulating growth. Hair implant surgery may be the answer for individuals who feel uncomfortable with any of these options.

Because mini-grafting is generally the surgical treatment of choice for areas with little hair loss, good candidates for this procedure are those who have dense hair growth on the back of the head. Mini-grafts are taken from this dense area and replaced in areas with little hair, giving volume to the hair region. Occasionally, flaps and tissue expansion procedures may be used if the individual is considered a good candidate for the procedure. If you are considering undergoing hair transplant surgery, it is important to understand that you will never have the same fullness that you had before your hair loss, however, the surgery can camouflage the deficient areas and give you a little more fullness.

Hair implant surgery is an individualized treatment. To be sure of the surgical option that best suits you, look for a doctor who has experience performing all types of hair transplant techniques.

At the first consultation, the surgeon will evaluate your hair growth and loss, review your family history of hair loss, and ask you if you have had any hair transplant procedures. The surgeon will also ask you about your lifestyle and discuss your expectations about the surgery.

Medical conditions that may cause problems during or after surgery such as high blood pressure, blood clotting problems, or a tendency to keloids should also be checked by your doctor. It is important to tell your doctor if you are a smoker or if you take any drugs or medications, especially aspirin or other drugs, that affect clotting. If you decide to undergo surgery, the surgeon will explain to you about the anesthesia, the location where the surgery will be performed, and the risks and costs involved. If you have any doubts, don't hesitate to ask your doctor.

Ask about the procedure to be performed and the time it will take. Also ask what you will look like at the end of the procedure. And, in the case of grafts, what it will be like at the end of each stage of the treatment.

Hair transplant surgery is safest when performed by a qualified and experienced doctor. Still, people vary in their physical reactions and healing, and results are not entirely predictable.

As with any surgical procedure, infection may occur. Excessive bleeding and/or large scars, caused by tension, may occur due to some scalp reduction procedures. In transplant procedures, there is a risk that some of the grafts will not “take effect”. Although it is normal for the hair contained in the grafts to fall out before they regenerate in their new location, sometimes the skin dies and surgery must be repeated. Sometimes hair graft patients notice small bumps on their scalp that form at the transplant sites. These areas can usually be camouflaged with surrounding hair.

Your surgeon will give you specific instructions on how to prepare for surgery, including guidance on eating and drinking, smoking, taking and avoiding certain vitamins and medications. If you smoke, it is important that you stop smoking at least a week or two before surgery. Smoking inhibits blood flow to the skin, which can interfere with healing.

Be sure to ask someone to accompany you and take you home after the procedure. For a day or two, try to calm down and ask for help if you need it.

The procedure must be carried out in a safe and comfortable place for the doctor and the patient, in a surgical center authorized by the Health Surveillance, with equipment and trained staff for any complications. The procedure rarely requires hospitalization.

Hair transplant surgery, regardless of the technique used, is generally performed using local anesthesia, along with sedation so that the patient is relaxed and comfortable. Your scalp will be numb to the pain, but you may feel some pulling or pressure. General anesthesia can be used for more complex cases involving tissue expansion or flaps.

Hair transplantation involves removing small pieces of hair grafts from a donor area and replacing them in an area with no or little hair. Grafts vary in size and shape. Round shaped grafts usually contain around 10-15 strands of hair. Mini-grafts contain about 2-4 hairs and micro-grafts contain about 1-2 hairs. More modern techniques use follicular units. Generally, several surgical sessions may be necessary to obtain the desired result and an interval of several months for healing is normally recommended between each session. It can take up to two years to see the final result of the entire procedure. The amount of coverage you will need is, in part, dependent on the color and texture of your hair. Thick, gray or light-colored hair provides better coverage than fine, dark-colored hair. The number of units transplanted in the first session varies according to each individual, but the average is around 50. For mini-grafts and micro-grafts, the number can be up to 700 per session. For the technique using follicular units, this number reaches 800. Just before surgery, the “donor area” will be cut so that the grafts can be easily accessed and removed. For punch grafts , the doctor may use a tube-like instrument, especially made of sharp carbon steel, that pierces the graft and removes it from the donor area so that it can be replaced in the area to be covered, usually the frontal scalp. For other types of grafts, the doctor will use a scalpel to remove small sections of hair from the scalp, which will be divided into small sections and transplanted into small holes or crevices in the scalp. When the grafts are removed, the doctor may periodically inject small amounts of saline into the scalp to maintain adequate skin strength. The holes at the donor site can be closed with stitches – for punch grafts , a single stitch can close each hole; for other types of graft, there will be a small linear scar. The spots are usually hidden by the surrounding hair. In subsequent sessions, the spaces between the grafts will be filled with additional grafts. Your doctor will take great care in removing and placing grafts to ensure that the transplanted hair grows in a natural direction and that hair growth in the donor area is not hindered. After the session is complete, the scalp will be cleaned and covered with gauze. You may need to wear a compression bandage for a day or two. Some doctors prefer not to use bandages.

Plastic surgeons are leaders in tissue expansion, a procedure commonly used in reconstructive surgery to repair burns and injuries with significant skin loss. Its application in hair transplant surgery has shown excellent results in a relatively short period of time.
In this technique, a balloon-like device called a tissue expander is inserted beneath the scalp, close to the bald area. The device is gradually inflated with saline over a few weeks, causing the skin to expand and new skin cells to grow. This procedure creates a bulge under the scalp, particularly after several weeks. When the skin under the hair has been stretched enough, usually about two months after surgery, another procedure is performed to bring the expanded skin over the area to cover the area adjacent to the bald area.

Scalp flap surgery has been performed successfully for over 20 years. This procedure is capable of quickly covering large areas of baldness and is specific to each patient. The size of the flap and its placement are largely dependent on the patient's goals and needs. One flap replaces 350 or more punch grafts . A section of bald scalp is cut and a flap is peeled away from the surface while still attached at one end. The flap is brought to its new position and stitched, remaining connected to its original blood supply. As healing occurs, you will notice that the scar becomes camouflaged – or at least obscured by the hair, which grows along the edge of the incision. In recent years, plastic surgeons have made significant advances in flap techniques, combining flap and scalp reduction surgery for better crown coverage, or with tissue expansion to provide better frontal coverage and a more natural line. of the hair.

This technique is often referred to as advancing flap surgery because sections of the scalp are pulled forward or “advanced” to fill in a bald area. Scalp reduction is to cover bald areas on the top and back of the head. It is not beneficial for covering the frontal hairline. After local anesthesia is applied to the scalp, a segment of bald scalp is removed. The cutting pattern of the scalp removed varies greatly depending on the patient's goals. If a large amount of coverage is needed, doctors often remove an inverted Y-shaped segment of scalp. Excisions may also be shaped like a U, a pointed oval, or some other figure. The skin around the area is loosened and removed so that the sections of hair on the scalp can be joined together and closed with stitches. You will likely feel a strong pull at this point and some pain.

Before: Hair transplant candidates must have noticeable hair loss, and healthy hair growth on the back and sides of the head to serve as a donor area.

Step 1: A tube-like instrument (punch) removes round grafts from the donor site to be placed in the area where the hair will be replaced. If the follicular unit technique is used, an elliptical scalp incision from the donor area (back of the head) and follicular units are separated with microscopes. Micro incisions are used to position the grafts in the recipient area.

Step 2: When the skin underneath the hair has stretched enough, it is surgically placed over the bald area.

Step 3: During flap surgery, a section of bald scalp is cut and a flap is sewn in its place.

Step 4: The patterns used in scalp reduction vary greatly, but they all accomplish the goal of bringing the hair and scalp together to cover bald areas.

After: The results of hair transplant surgery can improve your appearance and self-confidence.

How you feel after surgery will depend on the extent and complexity of the procedure. Pain, throbbing and excessive tension can be controlled with pain medication prescribed by your doctor. If bandages are used, they are normally removed the following day. You can wash your hair thoroughly within two days after surgery. Any stitches will be removed in a week to 10 days. Discuss with your doctor the possibility of swelling, bruising (bruising) and drainage. Because strenuous activities increase blood flow to the scalp and can cause bleeding, you will be advised to avoid intense exercise and contact sports for at least three weeks. Some doctors also advise that sexual activity be avoided for at least 10 days after surgery. To make sure the incisions have healed properly, your doctor will probably want to see you several times during the first month after surgery. It is important that you follow medical instructions and attend follow-up appointments.

The time it will take you to return to your normal routine depends on the extent, complexity and type of surgery you have undergone. You may feel well enough to return to work and resume normal light-intensity activities after a few days. Many patients who have had transplants or grafts are upset to learn that their “new” hair falls out within six weeks of surgery. Remember that this condition is normal and almost always temporary. After hair loss, it will take another five or six weeks for the hair to grow back.

It may be necessary to have a “touch-up” surgery so that the results are as natural as possible after the incisions have healed. Sometimes this procedure involves filling in the hairline using a combination of techniques. Or, if you have undergone the flap procedure, a small bump may be visible on your scalp. The doctor can remove this bump surgically after complete healing.